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A tutorial-based website, called TeachingMedicine.com, provides physicians and trainees with the means to acquire and practice medical skills – especially their abilities in diagnostic interpretation, such as ECG, chest X-ray, echocardiography and ultrasound interpretation.

The participants then get valuable immediate feedback from a clinical expert.

And users can practice as often as necessary to acquire and retain the skills. The goal is to increase the competency level of trainees.

“TeachingMedicine.com started out in 2005 in a much different form. It was simply a place to store handouts – a pdf library if you will,” said Dr. Jason Waechter, an intensivist-anesthesiologist and clinical associate professor at the University of Calgary. Dr. Waechter has led the development of the website.

“In 2004, I was at UBC teaching ECG interpretation and created small group ECG practice workshops. Students with an expert mentor had two hours to cover 12 different ECGs to interpret and provide diagnosis – one attempt at each.”

Results from the workshop confirmed that one attempt at ECG interpretation doesn’t provide the means to master the skill.

The solution was to create an online format that provides theory, practice and expert feedback on a student’s ECG interpretation.

“It requires many rounds of practice and feedback to learn a skill such as ECG interpretation and to gain an accuracy of 80 percent or better.

Without enough practice, not only will a person’s diagnosis skills be inaccurate, but so will their treatment,” said Dr. Waechter. “An incorrect diagnosis and treatment can cause serious harm to a patient, or at the very least delay proper treatment.”

The web site currently features modules for ECG, chest X-ray, echocardiography, ultrasound and CT. There are 7,000 registered users to the website and there were 35,000 site visits in 2015, resulting in 400,000 minutes of learning. “The average site visit lasts approximately 16-minutes, so we know people are using it,” said Waechter.

For its part, medical school provides plenty of theory but often little or no structured practice. But TeachingMedicine.com offers unlimited access to practice a skill as often as necessary to retain the knowledge and provides immediate feedback.

“We offer tutorials followed by an opportunity for students to practice. We are constantly adding new content. We test it, get feedback, then make changes and revisions,” said Dr. Waechter.

Dr. Waechter has partnered with several Canadian medical schools (including McGill, University of Calgary, UBC, University of Saskatchewan and University of Ottawa) to make use of the website part of the required curriculum.

He is also in discussions with multiple U.S. medical schools. Yale Medical School was the first American school to formally start using the online modules for their medical students, with the University of North Dakota and UCSD (San Diego) following.

TeachingMedicine.com provides doctors and trainees with an opportunity to practice and/or maintain their medical-related skills, ensuring competency throughout the various stages of their career.

Dr. Waechter said the idea is based on Competency By Design (CBD), an initiative by the Royal College of Physicians and Surgeons of Canada to improve physician training and lifelong learning.

Training is organized around desired outcomes and ensures physicians demonstrate the medical skills and behaviours necessary to meet their patient’s needs whether they’re in residency or nearing retirement. “Everyone needs to maintain their skills – even established physicians. There are modules on the website that would be too advanced for a student, but with CME (continuing medical education) on the site, established doctors can maintain their echo skills.

And they can practice up to 50 different “focused TTE” cases over and over until their accuracy of diagnosis is high enough.”

Doctors of all ages practice medical skills at times that are convenient for them, and receive meaningful feedback from clinical mentors.

ECG and chest X-ray interpretation are skills needed by most practicing physicians.

They can practice multiple cases of ECG, chest X-ray or ultrasound interpretation, as often as required until they reach a high level of competency.

“I’m very passionate about teaching, and the positive feedback I receive from users makes my entire week,” said Dr. Waechter. “It’s a great feeling to have a hand in helping someone learn, acquire and maintain their skills.”

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